Under the generaldirection of the HID Audit Supervisor the lead coding specialist shall:
Monitor codingcompliance through retrospective reviews or audits of ICD and CPT codes assignedby the coding personnel
Monitor codingcompliance by performing focused audits on high-risk areas identified by theOffice of inspector General (OIG) and the Centers of Medicare and MedicaidServices (CMS)
Identify through focusedaudits operation and regulatory issues related to coding, documentation, andcompliance
Identify and alert totrends found in reviews or data through Summary Reports
Provide education andtraining for coders and other healthcare professionals in both one on one andgroup setting
Comply with Federal,State, and CSMC Compliance Manual requirements to assist in improved dataquality for reporting, and accurate billing and reimbursement of servicesrendered
Assist the HID CodingDepartment with coding of cases during shortage of staff. Perform additionactivities (e.g. Data quality reports, etc.) as assigned.
In addition, this particular positionmay also focus on research and resolution of claim edits identified through thecore abstractions system (EPIC) as well as the claim scrubber system (Emdeon).If assigned, the position will required will require a high level of researchcapabilities to be able to facilitate appropriate resolution. Expertorganizational skills to keep references in order. Experience in claim editsand/or denials management a plus.
Since its beginning in 1902, Cedars-Sinai has evolved to meet the healthcare needs of one of the most diverse regions in the nation, continually setting new standards in quality and innovation in patient care, research, teaching and community service. Today, Cedars-Sinai is widely known for its national leadership in transforming healthcare for the benefit of patients.Cedars-Sinai is one of the largest nonprofit academic medical centers in the U.S. with 886 licensed beds, 2,100 physicians, 2,800 nurses and thousands of other healthcare professionals and staff. Clinical programs range from primary care for preventing, diagnosing and treating common conditions to specialized treatments for rare, complex and advanced illnesses. In addition, Cedars-Sinai serves the community through its Medical Network, which includes the highly rated Cedars-Sinai Medical Group and Cedars-Sinai Health Associates. Cedars-Sinai has consistently been named one of America’s Best Hospitals by U.S. News & World Report, has received the National Research Corporation’s Consumer Choice Award 18 years in a row for providing the highest quality medical care in Los Angeles, and has the longest running Magnet desig...nation for nursing excellence in California. Cedars-Sinai is a leader in the clinical care and research of heart disease, cancer and brain disorders, among other areas. Pioneering research achievements include using cardiac stem cells to repair damaged hearts, developing minimally invasive surgical techniques and discovering new types of drugs to target cancer more precisely. Cedars-Sinai also impacts the future of healthcare through education programs that encompass everything from highly competitive medical residency and fellowship programs to a biomedical science and translational medicine PhD program, advanced training for nurses and educational opportunities for allied health professionals. Most notably, Cedars-Sinai demonstrates a longstanding commitment to strengthening the Los Angeles community through wide-ranging programs that improve the health of its most vulnerable residents.
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